Effects of Carotid Artery Stenting on Cerebral Hemodynamics and Cognitive Function in aCAS Patients

LI Dongsong; AO Jinjiang; WANG Ning; QU Mingfang; GAO Jinying

doi:10.13730/j.issn.1009-2595.2018.01.005

Abstract：Objective To investigate and analyze the effects of carotid artery stenting on cerebral hemodynamics and cognitive function in patients with asymptomatic carotid artery stenosis (aCAS) (stenosis＞70.0 ％).Methods A total of 100 aCAS patients were selected from May 2014 to May 2017,and treated with carotid artery stenting.The peak systolic blood flow velocity (PSV),pulsatility index (PI) and cerebrovascular reserve capacity (CVR) were measured by transcranial Doppler ultrasound(TCD) at 1 week before surgury and 3 months after.Alzheimer's disease assessment scalecognitive subscale (ADAS-Cog),mini-mental state examination (MMSE),trail making test-A (TMTA) and trail making test-B (TMTB) scores were observed and recorded.Based on the degree by the opening of collateral circulation,the patients were divided into complete open group and incomplete open group.The hemodynamic changes and cognitive changes of aCAS patients before and after operation were compared.Results The postoperative ADAS-Cog,MMSE,TMTA and TMTB scores were obviously improved (P＜0.05).The preoperative levels of PSV,PI and CVR were clearly higher than postoperative levels of them [(57.21 ± 22.41) cm/s vs.(97.45 ± 31.54) cm/s,(0.65 ± 0.15) vs.(0.91 ± 0.22),(17.93 ± 7.2) ％ vs.(31.43 ± 8.2) ％,P＜0.05].The postoperative levels of PSV,PI and CVR in both complete open group and incomplete open group were significantly higher than preoperative levels of them (P＜0.05),the degrees of increasement in the incomplete open group were much more than these in the complete open group (P＜0.05).Conclusion Carotid artery stenting can effectively improve cerebral hemodynamics in aCAS patients and enhance cognitive function,it is worthy clinical promotion.